Lower leg muscles

The gastrocnemius is in the back of the lower leg. Deep to the gastrocnemius (farther from the skin) is the soleus muscle. They share a common insertion via the Achille´s tendon.

Gastrocnemius

Origin:
1. medial head: just above medial condyle of femur
2. lateral head: just above lateral condyle of femur

Insertion: calcaneus via lateral portion of calcaneal tendon

Action:
1. plantarflex the ankle
2. knee flexion (when not weight bearing)
3. stabilizes ankle & knee when standing

Pain and symptoms associated with the Gastrocnemius muscle

– Pain in the arch of the foot
– Pain toward the outside of the back of the knee
– Pain toward the inside of the back of the knee
– Pain going down the inside of the inside of the lower leg
– Pain around the inside ankle
– Pain on the inside of the foot in the high arch

Activities that cause gastrocnemius pain and symptoms

– Walking uphill
– Climbing
– Climbing stairs
– Cycling
– Jumping
– Swimming with toes pointed (flutter kick)
– Wearing high heels
– Tight banded socks or stockings
– Using footstools and recliners that put pressure on the back of the calves
– Sitting in a chair with knees pressed against the seat
– Sleeping with the covers tucked in too tightly requiring the toes to remain in a pointed, downward position
– Immobility of the lower leg due to a cast or brace

Soleus is a powerful muscle in the back part of the lower leg (the calf). It runs from just below the knee to the heel, and is involved in standing and walking. It is closely connected to the gastrocnemius muscle and some anatomists consider them to be a single muscle, the triceps surae.

Origin:
1. upper fibula
2. soleal line of tibia

Insertion: calcaneus via medial portion of calcaneal tendon

Action: plantarflex the foot

Acting via the Achille´s tendon, the gastrocnemius and soleus cause plantar flexion. That is, they increase the angle between the foot and the leg. The soleus plays an important role in maintaining standing posture. Together, the gastrocnemius and the soleus are involved in walking, dancing, running, jumping…

Pain and symptoms associated with the Soleus muscle

– Pain in the heel often to the point of not being able to put weight on the heel
– Pain in the ankle
– Pain in the calf sometimes extending into the back of the knee
– Deep aching in the back of the knee
– Deep pain in the low back
– Hypersensitivity to touch in the lower back
– Poor circulation in the lower legs and feet
– Pain in the jaw and on the side of the head

Activities that cause soleus muscle pain and symptoms

– Walking uphill
– Climbing
– Climbing stairs
– Cycling
– Jumping
– Wearing high heels
– Using footstools and recliners that put pressure on the back of the calves
– Immobility of the lower leg due to a cast or brace

A calf muscle tear is graded from 1 to 3, with grade 3 being the most severe.

Grade 1 symptoms

Grade 1 calf strain is a minor tear with up to 10% of the muscle fibers affected. The athlete will feel a twinge of pain in the back of the lower leg. They may be able to carry on playing or competing in mild discomfort. There is likely to be tightness and aching in the calf muscles two to five days after injury.

Grade 2 symptoms

Symptoms of a grade 2 strain will be more severe than a grade one with up to 90% of the muscle fibers torn. A sharp pain at the back of the lower leg will be felt with significant pain walking. There is likely to be swelling in the calf muscle with mild to moderate bruising. Pain will be felt on resisted plantar flexion or pushing the foot downwards against resistance. There may be tightness and aching in the calf muscle for a week or more.

Grade 3 symptoms

There will be a severe immediate pain at the back of the lower leg. The athlete will be unable to continue and unable to walk. There will be considerable bruising and swelling appearing and the athlete will be unable to even contract the calf muscle. In the case of a full rupture, often there is deformity where the muscle can be seen to be bunched up towards the top of the calf. A grade three is a near, or complete rupture of the muscle.